Triptorelin (Decapeptyl® or Gonapeptyl®) for prostate cancer

Hormones are chemicals that our bodies make. Hormones act as messengers and help control how cells and organs work. Hormonal therapies are drugs that change the way hormones are made or how they work in the body.

Prostate cancer needs the hormone testosterone to grow. Almost all testosterone in men is made by the testicles.

Triptorelin stops the testicles from making testosterone. This reduces testosterone levels and may shrink the prostate cancer or stop it growing. Your doctor or nurse will explain how long you have triptorelin for.

There are 2 types of triptorelin. 

• Decapeptyl^® is given as an injection into a muscle (intramuscular). It can be given every 28 days (4 weeks), or as a longer-acting injection every 3 or 6 months. 
• Gonapeptyl^® is given as an injection under the skin (subcutaneously) of your tummy, buttock or thigh. Or it is injected into a muscle (intramuscular). It is given every 28 days (4 weeks).

A practice nurse at your GP surgery gives you the injection. If you are not able to visit the GP surgery, a district nurse can give you it at home. If you are taking any medicines to thin your blood, tell your doctor or nurse. Triptorelin may make you bruise more easily.

Your nurse or doctor will talk to you about your treatment plan.

The skin around the area that was injected may become:

• painful
• swollen
• red or darker. 

Let your doctor know if this happens. They will use a different area for each injection. Painkillers may help.

When you start this treatment, your testosterone levels may increase for the first few days or weeks. This may make some symptoms worse. Doctors call this tumour flare.

Your doctor may prescribe another hormonal therapy tablet to prevent or reduce tumour flare. You usually start taking these tablets before starting the hormonal therapy drug to treat the cancer. You may need to continue taking them for a few weeks.

This treatment can cause back pain. If you have any back pain, weakness, numbness or tingling in your legs, tell your doctor straight away. They may give you painkillers to help.

Hot flushes are a common side effect of this treatment. During a flush, your neck and face may feel warm and look red. Flushes may last from a few seconds up to 10 minutes. You may have sweats and then feel cold and clammy. Some people feel anxious or irritable during a hot flush.

There are things you can do to try to reduce flushes:

• Wear clothes made from natural fabrics, such as cotton.
• Wear layers of clothes that you can remove if you feel hot.
• Use cotton bed sheets and have layers of bedding that you can remove if you feel hot.
• Keep room temperatures cool or use a fan.
• Have cold drinks rather than hot ones. Try to avoid drinks with caffeine in them.

You may have fewer hot flushes and sweats as your body adjusts to hormonal treatment. Or your doctor can prescribe drugs to help. Flushes and sweats usually stop a few months after treatment finishes, but some people continue to have them.

You can read more about coping with hot flushes.

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.

This treatment can cause sleeping problems (insomnia). If you are finding it difficult to sleep, talk to your nurse or doctor.

This treatment may cause headaches. If you have headaches, tell your doctor. They may give you painkillers to help.

You may gain weight when you are having this treatment. Eating healthily and being active can help you keep to a healthy weight. Your doctor, nurse or a dietitian can give you more advice.

You may have some mood changes during this treatment. You may feel low or depressed. Let your doctor or nurse know if you notice any changes.

You may get pain in your muscles or joints. If this happens, tell your doctor so they can give you painkillers. Being physically active may help with the pain and keep your joints flexible. Keeping to a healthy weight may help too. Tell your doctor or nurse if the pain does not get better.

If you take this treatment for several months or more, you may get bone thinning. This is called osteoporosis. This can increase your risk of a broken bone (fracture). You may have bone density scans to check your bone health before and during treatment.

Doing regular exercise, such as walking, can improve your bone health. Eating a healthy diet can help too. Your doctor may prescribe drugs called bisphosphonates to help protect your bones. They may also advise you to take calcium and vitamin D supplements.

You may get a dry mouth. Drink plenty of fluids, and add sauces and gravies to your food to keep it moist. If you have dry lips, using a lip balm or Vaseline® can help.

This treatment may cause high blood pressure. Tell your doctor or nurse if you have ever had any problems with your blood pressure. Let them know if you feel dizzy or have any headaches.

Cancer and some cancer treatments can increase the risk of a blood clot. Symptoms of a blood clot include:

• throbbing pain, redness or swelling in a leg or arm
• suddenly feeling breathless or coughing
• sharp chest pain, which may be worse when you cough or take a deep breath.

If you have any of these symptoms, contact the hospital straight away on the 24-hour contact number you have been given. If you cannot get through to your doctor, call the NHS urgent advice number on 111.

A blood clot is serious, but it can be treated with drugs that thin the blood (anticoagulants). Your doctor or nurse can give you more information.

You can help reduce the risk of developing a blood clot by:

• staying active during treatment
• drinking plenty of fluids, especially water.

You may be given anticoagulants to help prevent a clot.

Your doctor will advise you not to make someone pregnant while having this treatment. The drug may harm the developing baby. It is important to use effective contraception during your treatment.

Some medicines can affect how this treatment works or be harmful when you are having it. Always tell your cancer doctor about any drugs you are taking or planning to take, such as:

• medicines you have been prescribed
• medicines you buy in a shop or chemist
• vitamins, herbal drugs and complementary therapies.

Tell other doctors, pharmacists or dentists who prescribe or give you medicines that you are having this cancer treatment.

You can visit the electronic Medicines Compendium (eMC) for more detailed information about your treatment.

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.